体位指导对巨大侵袭性垂体腺瘤患者神经内镜下经蝶手术效果及自我管理水平的影响  

Effects of position-guided intervention on the surgical effects of transsphenoidal neuroendoscopic surgery for patients with giant invasive pituitary adenoma and its effects on self-management level

作　　者：王坤 屈浙 田军 胡昱红 苏白玉 檀浩鹏 李建华 WANG Kun;QU Zhe;TIAN Jun(Shijiazhuang People’s Hospital,Hebei,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市人民医院,050011

出　　处：《河北医药》2022年第8期1230-1232,共3页Hebei Medical Journal

基　　金：石家庄市科学技术研究与发展指导计划项目(编号:171461563)。

摘　　要：目的探讨体位指导干预在巨大侵袭性垂体腺瘤患者神经内镜下经蝶手术效果及对自我管理水平的影响。方法选择2018年5月至2021年2月收治的巨大侵袭性垂体腺瘤患者68例,患者均行神经内镜下经蝶手术治疗,随机数字表法分为2组,每组34例。对照组采用常规护理,观察组联合体位指导干预,7 d后比较2组疼痛数字评分(NRS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、自我管理水平、知晓率及并发症发生率。结果护理7 d后观察组NRS、SDS、SAS评分低于对照组(P<0.05),自我决策、自我减压、正性态度及总分均高于对照组(P<0.05);观察组护理7 d后发病机制、手术方法及并发症预防知晓率高于对照组(P<0.05),围术期反流性食管炎、感染、吻合口瘘发生率低于对照组(P<0.05)。结论体位指导干预用于巨大侵袭性垂体腺瘤患者神经内镜下经蝶手术中,有助于减轻患者疼痛及焦虑、抑郁,提高患者自我管理水平和知晓率,可降低术后并发症发生率。Objective To investigate the effects of position-guided intervention on the surgical effects of transsphenoidal neuroendoscopic surgery for patients with giant invasive pituitary adenoma and its effects on self-management level of patients.Methods A total of 68 patients with giant invasive pituitary adenoma enrolled in the study,who were randomly divided into two groups,with 34 cases in each group.The patients in both groups were treated by neuroendoscopic transspinal surgery,then,the patients in control group were treated by routine nursing,however,the patients in observation group,on the basis of control group,were treated by position-guided intervention.After 7-day nursing intervention,the nursing effects,and pain digital score(NRS),anxiety Self-rating Scale(SAS),depression self-rating Scale(SDS),self-management level,awareness rate and the incidence of complications were observed and compared between the two groups.Results After 7-day nursing intervention,the scores of NRS,SDS and SAS in observation group were significantly lower than those in control group(P<0.05),and the scores of self-decision,self-decompression,positive attitude and total scores in observation group were significantly higher than those in control group(P<0.05).The awareness rate of pathogenesis,surgical methods and prevention of complications in observation group was significantly higher than that in control group(P<0.05).Moreover the incidence rates of perioperative reflux esophagitis,infection and anastomotic fistula in observation group were significantly higher than those in control group(P<0.05).Conclusion The position-guided intervention in transsphenoidal neuroendoscopic surgery for patients with giant invasive pituitary adenoma can relieve the pain,anxiety and depression emotion of patients,improve the self-management level of patients and awareness rate,and can reduce the incidence of postoperative complications,thus,which is worthy of application and popularization in clinical practice.

关 键 词：体位指导干预 巨大侵袭性垂体腺瘤 神经内镜 经蝶手术 自我管理水平 

分 类 号：R736.4[医药卫生—肿瘤]